Can I get augmentation using Mirapex twice a week?

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dm23
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Joined: Tue Mar 05, 2019 10:40 pm

Can I get augmentation using Mirapex twice a week?

Post by dm23 »

I've had RLS for more than 40 years and the only thing that works for me is Mirapex (it's like shutting off the RLS valve!) but I'm terrified of augmentation so I only take it once a week on average, sometimes twice, so I can catch up on my sleep (.25mg). So far so good after 6-7 years, and my doctor says I don't need to be concerned at this rate, but I'm curious to know if anyone else has done something similar to this and what their experience has been. (Hot showers and push-ups are what I use on the off nights!).

Rustsmith
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Re: Can I get augmentation using Mirapex twice a week?

Post by Rustsmith »

Although there are people who experience augmentation in a very short time after beginning treatment with a dopamine agonist, the fact that you have been doing this for so long would indicate that your approach will probably continue to work. RLS has a tendency to get worse with age, so you may eventually get to a point where you need more in the way of treatment than what you are currently using. But hopefully some of the current research studies will provide us all with more options by that time.

One question for you is whether your doctor is checking your ferritin level along with other blood tests for iron levels. It is important for anyone taking a dopamine agonist, like Mirapex, to have a ferritin level over 75. Low ferritin levels increase the chances of augmentation, although at once a week is probably not too much of an increase. However, getting your iron levels up to that point might also reduce the symptoms that you have on your non-Mirapex nights.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Can I get augmentation using Mirapex twice a week?

Post by ViewsAskew »

I would agree with Steve.

I augmented on it in about a week the first time. After I finally was able to stop it, I stayed off for a couple years. But, it also works very well for me and I wanted to reduce my opioid use, so I started using it again. Even though it only took a week for me to augment, I used it 2-4 times a week for a few years without any issues with augmentation. I tried taking it 2 days on, 2 off. I also took it every other night.

Eventually I had my serum ferritin raised - mine was VERY low. Once I had an iron infusion (three total so far), I stopped augmenting quickly. In this last year, I've taken it as long as 6 months without issue. At the 6 month mark, I stopped it for a month, then just recently started it again.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

dm23
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Joined: Tue Mar 05, 2019 10:40 pm

Re: Can I get augmentation using Mirapex twice a week?

Post by dm23 »

Dear Steve and Ann, I just realized that I never thanked you for your thoughtful replies to my posting. Thanks! David

ViewsAskew
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Re: Can I get augmentation using Mirapex twice a week?

Post by ViewsAskew »

dm23 wrote:Dear Steve and Ann, I just realized that I never thanked you for your thoughtful replies to my posting. Thanks! David
:thumbup:
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

legsbestill
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Re: Can I get augmentation using Mirapex twice a week?

Post by legsbestill »

I returned to pramipexole (mirapex) 18 months after withdrawing from a very high dose following augmentation. I stick to 0.088mg per day. At first I used it only 5 out of 7 days but now I take it every day and I take breaks every so often (one is due shortly which I am dreading). I supplement it with kratom or solpadeine on the occasional night where 0.088mg is insufficient (usually because I was unwise in my food or - worse - alcohol consumption during the day/evening). None of the other drug options work for me as well as pramipexole. I take 6mg of naltrexone daily also which I am hoping will help prevent augmentation - based on the experience of another poster on here a couple of years ago that naltrexone reversed his d/a induced augmentation and impulse control disorder. I also keep my serum ferritin as high as possible as there is a link between low serum ferritin and augmentation (corresponding with Ann's experience).

It is possible that I am fairly resistent to augmentation because even when I was on a very high dose of pramipexole and was definitely augmented, my symptoms were not as severe as those of others in augmentation and it took a long time before I augmented on the drug in spite of high doses.

In your shoes I would find it very difficult to limit myself to one or two days a week. I would be keen to see how long it would work if I took it more regularly.

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